The goal for the current project year is to further assess the contribution of psychotherapy to success in completing detoxification, retention in treatment, and treatment outcome for opioid-dependent patients applying for treatment with naltrexone. Prospective patients who have been screened and found appropriate for naltrexone treatment will be randomly assigned to a high intervention or low intervention treatment modality. Both treatment groups will receive the same intake procedure, medical care, detoxification from opioids and induction onto naltrexone. Patients in the high intervention group will be assigned to an experienced psychotherapist for regularly scheduled therapy sessions that will include family members or "significant other". Patients in the low group will be assigned to a case manager for crisis intervention and the provision of concrete services. Maximum length of treatment for both groups will be one year. The amount of contact time with staff for each subject will be recorded. The treatment groups will be compared with respect to success in detoxification, retention in treatment, illicit drug use and opiate use at 3, 6 and 12 months after starting naltrexone.